| Entity Name: | COUNTRY CLUB PT, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 05 Mar 2010 (15 years ago) |
| Date of dissolution: | 30 Dec 2015 (9 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 30 Dec 2015 (9 years ago) |
| Document Number: | P10000019855 |
| FEI/EIN Number | 272909326 |
| Address: | 12816 Longford Rd, NORTH PALM BEACH, FL, 33408, US |
| Mail Address: | 12816 Longford Rd, NORTH PALM BEACH, FL, 33408, US |
| ZIP code: | 33408 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578928420 | 2015-12-19 | 2015-12-19 | 1331 WHISPERING LN, VENICE, FL, 342856449, US | 1331 WHISPERING LN, VENICE, FL, 342856449, US | |||||||||||||||||
|
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| Phone | +1 941-451-6689 |
Authorized person
| Name | LISA CORN |
| Role | OFFICE MANAGER |
| Phone | 9414516689 |
Taxonomy
| Taxonomy Code | 2251G0304X - Geriatric Physical Therapist |
| License Number | PT21464 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Sheehan Susan | Agent | 12816 Longford Rd, NORTH PALM BEACH, FL, 33408 |
| Name | Role | Address |
|---|---|---|
| SHEEHAN SUSAN | President | 12816 Longford Rd, North Palm Beach, FL, 33408 |
| Name | Role | Address |
|---|---|---|
| SHEEHAN SUSAN | Treasurer | 12816 Longford Rd, North Palm Beach, FL, 33408 |
| Name | Role | Address |
|---|---|---|
| SHEEHAN SUSAN | Director | 12816 Longford Rd, North Palm Beach, FL, 33408 |
| Name | Role | Address |
|---|---|---|
| CORN MATTHEW | Vice President | 1331 WHISPERING LN, VENICE, FL, 34285 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000127554 | COUNTRY CLUB PHYSICAL THERAPY | EXPIRED | 2015-12-17 | 2020-12-31 | No data | 350 W VENICE AVE., UNIT 1946, VENICE, FL, 34285 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2015-12-30 | No data | No data |
| AMENDMENT | 2015-10-12 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-01-12 | 12816 Longford Rd, NORTH PALM BEACH, FL 33408 | No data |
| CHANGE OF MAILING ADDRESS | 2015-01-12 | 12816 Longford Rd, NORTH PALM BEACH, FL 33408 | No data |
| REGISTERED AGENT NAME CHANGED | 2015-01-12 | Sheehan, Susan | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-01-12 | 12816 Longford Rd, NORTH PALM BEACH, FL 33408 | No data |
| REINSTATEMENT | 2011-11-14 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2015-12-30 |
| Amendment | 2015-10-12 |
| ANNUAL REPORT | 2015-01-12 |
| ANNUAL REPORT | 2014-04-28 |
| ANNUAL REPORT | 2013-05-24 |
| ANNUAL REPORT | 2012-03-20 |
| REINSTATEMENT | 2011-11-14 |
| Domestic Profit | 2010-03-05 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
